Find answers to your questions

Getting Started

We value your partnership.

Choosing the right plan for your client's employees and their families is easy with our help. Our Business Development team consists of Benefit Consultants and Account Managers assigned to each of the brokers who work with us and can help you every step of the way. To become appointed with Health Options, contact our Business Development Department directly at (207) 402-3353 or email us at BusinessDevelopmentInfo@healthoptions.org.

Working With Us

Accessing the Broker Portal

The broker portal allows access to account management and quoting tools to help you work with your clients, and your team. If you need help accessing your broker portal or would like assistance with a group client, please contact your Account Team at (207) 402-3353. For questions regarding an individual Member, please contact Member Services at (855) 624-6463.

Commissions

Broker commissions are paid no later than the end of the month for any commissions earned from the previous month. If a broker takes over an existing group account, Health Options requires a signed Broker of Record Letter from the employer group before commissions can be paid. Broker of Record Letters must be submitted on the employer group’s company letterhead and should be submitted directly to your Health Options Account Manager for processing.

Tax Forms

1099 B

1099 Forms are mailed to brokers prior to the end of January each year. Contact your account manager, or call Business Development for further assistance at (207) 402-3353.

Transparency Information

Transparency in Coverage Regulations

Transparency regulations require health insurers and group health plans to disclose pricing information in machine-readable files (MRF). In-network files include negotiated rates with in-network providers; out-of-network files include allowed amounts and billed charges from out-of-network providers. Public access to these files may be found on this page. The presentation of MRFs follow the Centers for Medicare & Medicaid Services (CMS) defined layout and format and will be updated every 30 days.

Machine-readable files are not meant to be consumer-friendly—they are a digital representation of data or information in a file that can be imported or read by a computer system. To understand Member benefits and cost sharing, please contact Member Services at (855) 624-6463.

We value your partnership.

Choosing the right plan for your client's employees and their families is easy with our help. Our Business Development team consists of Benefit Consultants and Account Managers assigned to each of the brokers who work with us and can help you every step of the way. To become appointed with Health Options, contact our Business Development Department directly at (207) 402-3353 or email us at BusinessDevelopmentInfo@healthoptions.org.

Accessing the Broker Portal

The broker portal allows access to account management and quoting tools to help you work with your clients, and your team. If you need help accessing your broker portal or would like assistance with a group client, please contact your Account Team at (207) 402-3353. For questions regarding an individual Member, please contact Member Services at (855) 624-6463.

Commissions

Broker commissions are paid no later than the end of the month for any commissions earned from the previous month. If a broker takes over an existing group account, Health Options requires a signed Broker of Record Letter from the employer group before commissions can be paid. Broker of Record Letters must be submitted on the employer group’s company letterhead and should be submitted directly to your Health Options Account Manager for processing.

1099 B

1099 Forms are mailed to brokers prior to the end of January each year. Contact your account manager, or call Business Development for further assistance at (207) 402-3353.

Transparency in Coverage Regulations

Transparency regulations require health insurers and group health plans to disclose pricing information in machine-readable files (MRF). In-network files include negotiated rates with in-network providers; out-of-network files include allowed amounts and billed charges from out-of-network providers. Public access to these files may be found on this page. The presentation of MRFs follow the Centers for Medicare & Medicaid Services (CMS) defined layout and format and will be updated every 30 days.

Machine-readable files are not meant to be consumer-friendly—they are a digital representation of data or information in a file that can be imported or read by a computer system. To understand Member benefits and cost sharing, please contact Member Services at (855) 624-6463.

Use this form to apply for Community Health Options individual, direct-enroll health insurance coverage or to make changes to an existing direct-enroll policy. It’s important to complete all questions and sign this form before submitting your request. If you have any questions, please contact our Member Services team at (855) 624-6463. Note: Members with policies initiated through the Maine Health Insurance Marketplace (CoverME.gov) must contact the Marketplace to make a change to an existing enrollment.

Use this form to apply for Community Health Options individual, direct-enroll health insurance coverage or to make changes to an existing direct-enroll policy. It’s important to complete all questions and sign this form before submitting your request. If you have any questions, please contact our Member Services team at (855) 624-6463. Note: Members with policies initiated through the Maine Health Insurance Marketplace (CoverME.gov) must contact the Marketplace to make a change to an existing enrollment.

Use this form to add, remove, or change an enrollment of an employee or dependent in a 2023 enrolled plan. 

Use this form to add, remove, or change an enrollment of an employee or dependent in a 2022 enrolled plan. 

Review this document for a full overview of our 2023 Individual and Family Plans, offered on and off the Marketplace. 

Use this guide to look up information about your plan benefits and how to use them to access care.

Use this guide to look up information about your plan benefits and how to use them to access care.

For Members who access health insurance through their employer: Use this guide to look up information about your plan benefits and how to use them to access care. Contact Business Development at (207) 402-3330 for assistance.

Urgent care is available without an appointment and is typically less expensive than the emergency room. Use this list to find a regional urgent care center near you.

Our Chronic Illness Support Program (CISP) is designed to reduce financial barriers for Members with asthma, coronary artery disease (CAD), chronic obstructive pulmonary disease (COPD), diabetes, hypertension. Learn more about CISP with this document.

Use this guide to get started with Express Scripts, our pharmacy benefit manager. Express Scripts offers online prescription ordering, auto-generated comparisons, suggestions for lower cost prescription options and home delivery.

Health insurance Open Enrollment takes place every year between November 1 and December 15. Certain qualifying events, such as marriage, birth and moving out of coverage areas, can qualify you for Special Enrollment Period. Use this guide to learn more.

Outside of employer Open Enrollment, certain qualifying events, such as marriage, birth, adoption, or employment status change, can qualify group Members for a Special Enrollment Period. Use this guide to learn more.